The Effects Of Respiratory Mechanics Of Different Oxygen Concentrations On Recruitment Maneuver During Mechanical Ventilation With The Patients Of Acute Respiratory Distress Syndrome

Objective:To monitor the levels of respiratory mechanics,blood gas values and hemodynamics of patients with acute respiratory distress syndrome during four different oxygen concentrations on recruitment maneuver(RM).To present a better oxygen concentration which can improve and stabilize the levels of respiratory mechanics,oxygenation and hemodynamics of ARDS patients who were recruitmented.Method: A total of 80 patients with ARDS requiring mechanical ventilated were included.Apply the method of self-control randomized and prospective,four oxygen concentrations of maneuverwere randomized to each patient:(1)group A,oxygen concentration(Fi O2)was 30%,(2)group B,Fi O2 was 40%,(3)group C,Fi O2 was 50%,(4)group D,Fi O2 was 60%.Compared the difference of Pplat,Ppeak,recruited volume,Cst,Pa O2,Sa O2,Pa O2/Fi O2,MAP and CVP in four groups before and after recruitment maneuvers.Repeated measurement data using SPSS17.0 statistical software for statistical analysis.Measurement data were presented as mean ± standard deviation,different oxygen concentrations and groups compared using repeated measures MANOVA.Results: 1.Effect on respiratory mechanics: there was no difference before RM(P>0.05),After RM,recruited volume were significantly increased in four groups(P<0.05).Compared with group A,C and D,patients in group B had a more increasing on recruited volume(P<0.05).Platform pressure and peak pressure were decreased on T3 in group B,C and D(P>0.05);Platform pressure,peak pressure and static compliance of the lung were improved on T2 in group B(P<0.05),but no difference in other three groups(P>0.05).2.Effect on blood gas: there was no difference before RM(P>0.05).But after RM,the levels of Pa O2,Sa O2 and Pa O2/Fi O2 were higher than before(P<0.05).There was a significant difference compared with four groups in Pa O2 and Pa O2/Fi O2 after RM(P<0.05).There was no difference of Pa CO2 and PH in four groups through the whole trial(P>0.05).3.Effect on hemodynamics: there was no difference before RM with the levels of MAP,CVP and HR,they varied during RM in all groups(P>0.05),but then reached before 5 min after RM.Conclusion: 1.Different oxygen concentrations on RM could change the levels of respiratory mechanics and oxygenation of patients with ARDS,and hemodynamics suffered briefly.2.Maintaining oxygen concentration with 40% during RM may be more beneficial in terms of respiratory mechanics and recruited volume,it could content to supply enough oxygen and avoid hyperoxia induced injury.3.No severe complicationoccurred during the trial,RM is safe and effective.